Broadhurst M Jana, Brooks Tim J G, Pollock Nira R
Department of Pathology, Stanford University School of Medicine, Palo Alto, California, USA
Public Health England, Porton Down, Salisbury, United Kingdom.
Clin Microbiol Rev. 2016 Oct;29(4):773-93. doi: 10.1128/CMR.00003-16.
Laboratory diagnosis of Ebola virus disease plays a critical role in outbreak response efforts; however, establishing safe and expeditious testing strategies for this high-biosafety-level pathogen in resource-poor environments remains extremely challenging. Since the discovery of Ebola virus in 1976 via traditional viral culture techniques and electron microscopy, diagnostic methodologies have trended toward faster, more accurate molecular assays. Importantly, technological advances have been paired with increasing efforts to support decentralized diagnostic testing capacity that can be deployed at or near the point of patient care. The unprecedented scope of the 2014-2015 West Africa Ebola epidemic spurred tremendous innovation in this arena, and a variety of new diagnostic platforms that have the potential both to immediately improve ongoing surveillance efforts in West Africa and to transform future outbreak responses have reached the field. In this review, we describe the evolution of Ebola virus disease diagnostic testing and efforts to deploy field diagnostic laboratories in prior outbreaks. We then explore the diagnostic challenges pervading the 2014-2015 epidemic and provide a comprehensive examination of novel diagnostic tests that are likely to address some of these challenges moving forward.
埃博拉病毒病的实验室诊断在疫情应对工作中发挥着关键作用；然而，在资源匮乏的环境中为这种高生物安全等级的病原体建立安全、快速的检测策略仍然极具挑战性。自1976年通过传统病毒培养技术和电子显微镜发现埃博拉病毒以来，诊断方法已趋向于更快、更准确的分子检测。重要的是，技术进步与支持可在患者护理点或其附近部署的分散式诊断检测能力的努力不断增加相匹配。2014 - 2015年西非埃博拉疫情的空前规模推动了该领域的巨大创新，多种新型诊断平台已投入使用，这些平台既有潜力立即改善西非正在进行的监测工作，又能改变未来的疫情应对方式。在本综述中，我们描述了埃博拉病毒病诊断检测的演变以及在以往疫情中部署现场诊断实验室的努力。然后，我们探讨了贯穿2014 - 2015年疫情的诊断挑战，并全面审视了可能应对未来一些此类挑战的新型诊断检测方法。
